Effects of Hurricane Katrina on Nursing Facility Resident Mortality, Hospitalization, and Functional Decline

Abstract

<jats:title>ABSTRACT</jats:title><jats:p><jats:bold>Background:</jats:bold> The study was designed to examine the 30- and 90-day mortality and hospitalization rates among nursing facility (NF) residents in the affected areas of Louisiana and Mississippi following Hurricane Katrina and to assess the rate of significant posthurricane functional decline.</jats:p><jats:p><jats:bold>Methods:</jats:bold> A secondary data analysis was conducted using Medicare claims merged with NF resident data from the Minimum Data Set. Thirty- and 90-day mortality and hospitalization rates for long-stay (&gt;90 days) residents residing in 141 at-risk NFs during Hurricane Katrina were compared to rates for residents residing at the same facilities during the same time period in prior nonhurricane years (2003 and 2004). Functional decline was assessed as a 4+ drop in function using a 28-point Minimum Data Set Activities of Daily Living Scale.</jats:p><jats:p><jats:bold>Results:</jats:bold> There were statistically significant differences (all <jats:italic>P</jats:italic> &lt; .0001) in mortality, hospitalization, and functional decline among residents exposed to Hurricane Katrina. At 30 days, the mortality rate was 3.88% among the exposed cohort compared with 2.10% and 2.28% for residents in 2003 and 2004, respectively. The 90-day mortality rate was 9.27% compared with 6.71% and 6.31%, respectively. These mortality differences translated into an additional 148 deaths at 30 days and 230 deaths at 90 days. The 30-day hospitalization rate was 9.87% compared with 7.21% and 7.53%, respectively. The 90-day hospitalization rate was 20.39% compared with 18.61% and 17.82%, respectively. Finally, the rate of significant functional decline among survivors was 6.77% compared with 5.81% in 2003 and 5.10% in 2004.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> NF residents experienced a significant increase in mortality, hospitalization, and functional decline during Hurricane Katrina.</jats:p><jats:p>(<jats:italic>Disaster Med Public Health Preparedness</jats:italic>. 2010;4:S28-S32)</jats:p>

To Evacuate or Shelter in Place: Implications of Universal Hurricane Evacuation Policies on Nursing Home Residents

“…Finally, NHs from counties/parishes where there were no known evacuations were removed. 4 The geographic exposure region for each of the four storms is available from the author.…”

“…Less than a month later, 72 facilities evacuated in the same region prior to Hurricane Rita. 4 In 2008, 119 facilities evacuated prior to Hurricane Gustav and 81 facilities evacuated prior to Hurricane Ike, even though it made landfall far south of the evacuated Louisiana facilities. i …”

The Effects of Evacuation on Nursing Home Residents With Dementia

“…Dosa and colleagues found that evacuation, and not storm effects experienced while sheltering in place, contributed significantly to increased rates of hospitalization, morbidity, and mortality of nursing home residents. 2,6 …”

Improving Long-Term Care Facility Disaster Preparedness and Response: A Literature Review

“…Five of these compared health outcomes of nursing home residents in facilities that experienced a disaster compared with a control cohort of patients in facilities that did not experience a disaster. [30][31][32][33][34] Dosa et al 30 studied 30-day mortality, 90-day mortality, hospitalization rates, and measurements of functional decline for 9260 residents from 141 long-term care facilities in Louisiana and Mississippi that were impacted by Hurricane Katrina in 2005 and then compared the data with data for residents residing in the same facility during the 2 prior nonhurricane years (see Table S2 in the online data supplement). Many of these facilities evacuated.…”